{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:33:04Z","timestamp":1792153984172,"version":"4.4.0"},"reference-count":76,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T00:00:00Z","timestamp":1605484800000},"content-version":"vor","delay-in-days":685,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Over the past few years non-cardiac surgery has been recognised as a serious circulatory stress test which may trigger cardiovascular events such as myocardial infarction, in particular in patients at high risk. Detection of these postoperative cardiovascular events is difficult as clinical symptoms often go unnoticed. To improve detection, guidelines advise to perform routine postoperative assessment of cardiac troponin. Troponin elevation \u2013 or postoperative myocardial injury \u2013 can be caused by myocardial infarction. However, also non-coronary causes, such as cardiac arrhythmias, sepsis and pulmonary embolism, may play a role in a considerable number of patients with postoperative myocardial injury. It is crucial to acquire more knowledge about the underlying mechanisms of postoperative myocardial injury because effective prevention and treatment options are lacking. Preoperative administration of beta-blockers, aspirin, statins, clonidine, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, and preoperative revascularisation have all been investigated as preventive options. Of these, only statins should be considered as the initiation or reload of statins may reduce the risk of postoperative myocardial injury. There is also not enough evidence for intraoperative measures such blood pressure optimisation or intensified medical therapy once patients have developed postoperative myocardial injury. Given the impact, better preoperative identification of patients at risk of postoperative myocardial injury, for example using preoperatively measured biomarkers, would be helpful to improve cardiac optimisation.<\/jats:p>","DOI":"10.1177\/2047487318798925","type":"journal-article","created":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T12:58:17Z","timestamp":1536757097000},"page":"59-67","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Causes and prevention of postoperative myocardial injury"],"prefix":"10.1093","volume":"26","author":[{"given":"Laura","family":"Verbree-Willemsen","sequence":"first","affiliation":[{"name":"Department of Epidemiology , Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remco B","family":"Grobben","sequence":"additional","affiliation":[{"name":"Department of Cardiology , University Medical Center Utrecht, Utrecht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith AR","family":"van Waes","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology , University Medical Center Utrecht, Utrecht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M","family":"Peelen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology , Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands"},{"name":"Department of Anaesthesiology , University Medical Center Utrecht, Utrecht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik M","family":"Nathoe","sequence":"additional","affiliation":[{"name":"Department of Cardiology , University Medical Center Utrecht, Utrecht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilton A","family":"van Klei","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology , University Medical Center Utrecht, Utrecht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederick E","family":"Grobbee","sequence":"additional","affiliation":[{"name":"Department of Epidemiology , Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the CHASE investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,29]]},"reference":[{"key":"2023040618234803700_","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1503\/cmaj.050011","article-title":"Perioperative 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